Journal of Stomatology Oral and Maxillofacial Surgery最新文献

Purpose: To analyze dynamic and static changes in the disc-condyle relationship in patients with skeletal Class III malocclusion after orthognathic surgery.

Methods: The surgical group comprised 30 patients with skeletal Class III malocclusion, and the magnetic resonance imaging and mandibular movement data were obtained at T0 (preoperatively), T1 (3 months postoperatively), and T2 (at the end of orthodontic treatment). The control group included 20 patients with normal occlusion, and the mandibular movement data were recorded.

Results: The maximum mouth opening at T1 decreased compared with that at T0 and recovered close to the preoperative level at T2. The marginal movement of the mandible at T1 decreased compared with that at T0 (P > 0.05), among which the movement distances of the condyles during mouth opening and closing decreased significantly compared with those at T0(P < 0.05). Following postoperative orthodontics in patients with skeletal Class III malocclusion, RET-L was significantly lower than that in the control group(P < 0.05).Regarding the temporomandibular joint of ADDwR, the CPL at T1 decreased significantly compared with that at T0(P < 0.05). At T2, the LPM, LLM, and CPL increased significantly compared with those at T1(P < 0.05), and the LPM and LLM levels at T2 exceeded those at T0 significantly (P < 0.05).

Conclusions: In the short term, after orthognathic surgery, the marginal movement of the mandible showed a certain degree of decline; however, in the long term, it recovered or even exceeded the preoperative level. Orthognathic surgery results in a particularly significant improvement in the functional movement of the ADDwR joint. In addition, it improves TMD in patients with skeletal Class III malocclusion and has a positive effect on improving the position of the joint disc position.

Background: Temporomandibular disorders (TMD) and orthodontic treatment are significant areas within dental and maxillofacial research. However, comprehensive bibliometric analyses highlighting global trends and collaboration networks are lacking.

Objective(s): This study aims to systematically map the publication landscape, identify prevailing research trends, highlight influential authors and institutions, and illuminate emerging topics in TMD and orthodontic research.

Methods: Publications concerning TMD and orthodontic treatment from 2000 to 2024 were retrieved from the Web of Science Core Collection. A bibliometric analysis was conducted using VOSviewer, CiteSpace, and R to evaluate co-authorship networks, institutional collaborations, and keyword co-occurrence patterns.

Results: A total of 871 publications were identified, with an average annual growth rate of 4.4 %. Contributions came from 47 countries and involved 3,463 authors, with the USA and Japan leading in citations. Notable institutions included Kyung Hee University and Baylor University. Key journals included the American Journal of Orthodontics and Dentofacial Orthopedics and the Journal of Oral and Maxillofacial Surgery. Frequently occurring keywords were "temporomandibular-joint," "orthognathic surgery," and "orthodontic treatment," indicating essential research foci. Emerging trends highlighted advancements in surgical techniques and technological innovations in orthodontics.

Conclusion: This bibliometric analysis offers valuable insights into global research trends and hotspots in TMD and orthodontic treatment, emphasizing the collaborative nature of the field and illuminating emerging areas for future investigation.

Introduction: Orthognathic surgery is a fundamental component of a maxillofacial surgeon's practice. In France, 510 specialists actively practice oral and maxillofacial surgery. In OMFs, despite the existence of evidence-based recommendation that address diagnosis, treatment planning, and operating methods, each surgeon/institution has developed an individual approach towards clinical management. This study comprehensively overviews the current practices of French orthognathic surgeons.

Methods: A questionnaire was electronically sent to 500 oral and maxillofacial surgeons in France, some of whom practiced orthognathic surgery and some of whom did not. The answers were anonymous.

Results: We obtained 52 responses. With consensus on 12 of the practical, economic, and peri-operative questions. We didn't find difference on any topics where the surgeon has his residence or the age of the surgeon. Management and correction of occlusal disorders were the primary indications for osteotomy. Of all responders, 42 % were in private practice. Both virtual and conventional planning methods were used, with no clear preference for either method. During bimaxillary surgery, 76 % of surgeons initially osteotomised and stabilised the maxilla; 69 % used an intermediate splint. ERAS protocols are not used.

Conclusion: This study is an update and it provides new information compared a 2002 report on orthognathic surgery in France. It highlights a consensus on conventional planning but no significant influence from academic centers, age, or experience on surgical practices. New technologies and ERAS protocols are underused despite their benefits for safer surgeries. There is a lack of standardized procedures, leading to varied practices despite a national teaching program. More data and practitioner involvement are needed to develop French and European guidelines.

Background: Facial palsy (FP) is a widespread condition affecting over 3 million people annually, with a complex etiology requiring tailored, multidisciplinary management. Despite advancements, there remains a lack of reliable, automated tools for objective pre- and postoperative assessment, limiting progress in treatment optimization. This study introduces the AI Research Metrics Model (CAARISMA ® ARMM) to evaluate FP severity and outcomes following microsurgical gracilis muscle transfer.

Methods: We analyzed pre- and postoperative images of 20 FP patients using CAARISMA ® ARMM, which identifies 17 facial landmarks and evaluates 1,030 parameters. CAARISMA ® ARMM calculates three indices: Facial Youthfulness Index (FYI), Facial Aesthetic Index (FAI), and Skin Quality Index (SQI). All surgical procedures were performed by the senior author. Statistical analysis compared preoperative and postoperative scores using independent t-tests and Wilcoxon-Mann-Whitney tests, with significance set at p < 0.05.

Results: Significant improvements were observed in the FAI scores post-surgery (p < 0.001). In contrast, FYI and SQI scores did not show significant postoperative changes (p = 0.39 and p = 0.60, respectively). Significant gender differences emerged: females showed increased FYI scores postoperatively, while males exhibited a decline (p = 0.0065). Age-related variations were also significant, with younger patients showing improved SQI and older patients experiencing declines (p = 0.040).

Conclusion: The CAARISMA ® ARMM effectively captures aesthetic improvements post-reanimation. Gender and age significantly influence outcomes, underscoring the key role of personalized and adaptable assessment tools. Future studies should integrate dynamic assessments and validate the CAARISMA ® ARMM across additional patient populations. CAARISMA ® ARMM holds promise as a standardized tool in FP outcome evaluation.

Background: Oral cancer, particularly mucoepidermoid carcinoma (MEC), presents diagnostic challenges due to its histological diversity and rarity. This study aimed to develop machine learning (ML) models to predict survival outcomes for MEC patients and pioneer a clinically accessible prognostic tool.

Methods: Using the SEER database (2000-2020), we constructed predictive models with five ML algorithms: Random Forest Classifier (RFC), Gradient Boosting Classifier (GBC), Logistic Regression (LR), K-Nearest Neighbors (KNN), and Multilayer Perceptron (MLP). Predictive variables were identified via Cox regression, and Kaplan-Meier analysis assessed survival trends. Model performance was validated through the area under the curve (AUC) of receiver operating characteristic (ROC) curves.

Results: This study included 1314 patients diagnosed with MEC of the oral cavity. The RFC demonstrated the highest predictive accuracy (AUC = 0.55), followed by the GBC and RFC (AUC = 0.53). The most affected primary site was the hard palate, followed by the retromolar and cheek mucosa. Survival rates varied with the treatment modality, with the highest rates observed in patients undergoing surgery alone. ML models have identified age, sex, and metastasis as significant prognostic factors influencing survival outcomes, underscoring the complexity and heterogeneity of MEC.

Conclusions: This study highlights ML's potential to enhance survival predictions and personalize treatment for MEC patients. We developed the first web-based prognostic tool, providing a novel, accessible solution for improving clinical decision-making in MEC.

Purpose: This in-vitro study aimed to compare the shear bond strength (SBS) of cobalt-chromium (Co-Cr) crowns on Corticobasal® implant abutments, evaluating the effects of two surface treatments and two luting agents.

Materials and methods: Thirty Co-Cr crowns were fabricated using CAD-CAM technology with a direct metal laser sintering process and divided into three groups based on surface treatment: Group I (untreated), Group II (sandblasted with 50 μm Al₂O₃), and Group III (Er: YAG laser etching). Each group was further subdivided based on luting cement: Sub group A (GC Fuji Plus) and Sub group B (Rely X U200). This resulted in a total of six groups. The implants were stabilized in auto-polymerizing acrylic resin, and cementation followed standardized protocols. Thermocycling with 1000 cycles (5 °C-55 °C) simulated oral conditions. SBS was tested using a universal testing machine at a crosshead speed of 1 mm/min. Failure patterns were analyzed using stereomicroscopy to classify adhesive, cohesive, and mixed failures. Statistical analysis was performed using one-way ANOVA and Bonferroni post-hoc tests (p < 0.05).

Results: Group IIIA (laser-treated, GC Fuji Plus) showed the highest SBS (243.15 MPa), followed by Group IIA (sandblasted + GC Fuji Plus), at 231.81 MPa. The lowest SBS was observed in Group IB (untreated, Rely X U200) at 124.24 MPa. Both sandblasting and laser treatment significantly enhanced SBS, with GC Fuji Plus consistently outperforming Rely X U200. A significant difference of 48.17 MPa was observed between laser-treated Groups IIIA and IIIB (p < 0.01).

Conclusion: Laser etching and GC Fuji Plus cementation provided the highest SBS for Co-Cr crowns on Corticobasal® implants. Sandblasting was a secondary effective treatment, while untreated crowns exhibited the weakest bond strength.

Backgound: The positioning of the reconstructed ear in ear reconstruction is a crucial step that directly affects the surgical outcome.This study employs the residual ear tissue as a reference, in conjunction with three-dimensional(3D)printing model of the normal ear's mirror image corresponding to the microtia ear, to facilitate precise positioning during the reconstruction of the ear.

Methods: This study established a 3D model group and a control group. The 3D model group utilized 3D printed models of residual ear tissue alongside the mirror image of the normal ear for positioning, while the control group relied on the surgeon's subjective observation.The symmetry of the reconstructed ear post-operation was evaluated by two independent physicians who were not involved in the surgical procedure for the patients.The patient was asked to use the Visual Analog Scale (VAS) to assess their satisfaction with ear symmetry and ear shape preoperative and postoperative 12 months.

Results: A total of 84 patients who met the inclusion criteria were enrolled in this study.In the 3D model group, no statistically significant differences were observed between the average distances from the highest and lowest points of the normal ear to the nasal axis and those of the reconstructed ear(P=0.688, P=0.916). Conversely, a statistically significant difference was noted in the control group (P=0.041; P=0.028).The 3D model group exhibited higher total scores on the VAS for patients' objective satisfaction CONCLUSION: The reconstructed ear can be accurately positioned by utilizing the residual ear tissue as a reference and employing 3D printing model with mirror technology.

Objective: This expert opinion presents provisional guidelines for addressing complications associated with Additively Manufactured Subperiosteal Jaw Implants (AMSJI®) in patients with severe maxillary atrophy. AMSJI®'s custom design, supported by finite element analysis (FEA), allows precise placement that avoids critical anatomical structures and minimizes complications relative to alternative solutions.

Materials and methods: Data were gathered through firsthand experiences, direct communications, two structured surveys and insights from international workgroup meetings.

Results: Minor complications, such as soft tissue recession with inflammation, can be managed through thorough patient selection and early intervention. Severe complications, such as ascending infections and mechanical issues (e.g., fractures of implant components), have been rare. Compared to zygomatic implants and bone grafting, AMSJI® demonstrates a favorable safety profile. Zygomatic implants may lead to severe issues like orbital cellulitis and diplopia, while bone grafting risks include graft resorption, loss, and donor site complications. To mitigate risks, selecting patients carefully and ensuring diligent follow-up are critical, especially in those with risk factors like smoking or bruxism. Improved imaging, planning, and FEA have further contributed to minimizing complications, reinforcing AMSJI®'s role in complex maxillary reconstructions and implant-supported prosthetics.

Conclusions: AMSJI® demonstrates high success rates but requires meticulous risk management. Key strategies involve carefully candidates by excluding those who are smokers, immunocompromised, or non-compliant, or diabetics with a history of infectious complications. Additionally, strict adherence to oral hygiene protocols is essential to optimize outcomes and minimize risks.Proactive management in these areas is crucial to optimize outcomes, ensure implant longevity, and support successful prosthetic rehabilitation.

Background: A specific pathological postural adaptation is suspected in patients exhibiting maxillo-mandibular deformity (MMD); however, none study reported a correlation between facial dimensions and posture. In this study, we hypothesized that pathological postural adaptations are related to long-face deformity and subsequent oral breathing in patients with MMD METHODS: Thirty patients with MMD and 20 healthy subjects. Breathing mode, postural alignment and cephalometry were analyzed through a biplanar X-ray (EOS imaging®) of the skeleton in an upright position, followed by three-dimensional reconstruction.

Results: Patients with MMD exhibited hyperkyphosis of the lower region of the cervical spine (C3-C7 angle: 10.6° [3.9; 17.5] vs. 3.2° [-6.4; 7.6], p < 0.01), forward head posture (OD-C7 angle: 10.5° [8.5; 15.1] vs. 6.2° [3.0; 8.4], p < 0.01), and backward sagittal balance compared with controls (sagittal vertical axis:15.7 mm [-25.9; -5.2] vs. -1.4 mm [-17.8; 7.0], p = 0.014). Cervical hyperkyphosis, the forward head posture, and the backward sagittal balance were related to higher values of the Frankfort-mandibular plane angle (a cephalometric variable used to assess face length). In patient with MMD, oral breathing was correlated to the FMA angle.

Conclusion: MMD is associated with a specific pathological postural adaptation which is correlated with Long-face deformity and oral breathing. Our results suggest that the altered posture originates from the upper airways.

Background: UL16-binding protein 2 (ULBP2) is significantly overexpressed in diverse cancers, it may also serve as a potential prognostic factor. Nonetheless, the mechanism of action and functions associated with ULBP2 in head and neck squamous cell carcinoma(HNSCC) are unexplored. This study aims to clarify the role and mechanism of ULBP2 in HNSCC and determine whether this molecule promotes tumor progression through modulation multiple downstream MAPK signaling.

Materials and methods: The Cancer Genome Atlas (TCGA) database was used to find out the mRNA transcript levels of ULBP2 in people with HNSCC. Here, the impact of ULBP2 on proliferation, migration and invasion abilities was evaluated in HNSCC cell lines using multi-methods. To understand the effect of ULBP2 on tumor-related signaling pathways, Genomic Enrichment Analysis (GSEA) was performed. We did an in vivo cancer study to learn more about the part ULBP2 plays in the growth of tumors. Moreover, Western blot was used to determine the signaling pathways influenced by ULBP2.

Results: ULBP2 is highly expressed in HNSCC cells. In addition, we saw that HNSCC patients who had high levels of ULBP2 had a poor prognosis. Silencing ULBP2 expression reduces invasive and metastatic abilities of HNSCC cells Mechanistic experiments showed the function of ULBP2 in vitro and in vivo tumorigenic assays potentially associated with MAPK pathway.

Conclusion: We validated that ULBP2 promotes HNSCC cell progression by regulating the MAPK pathway. These findings are crucial for understanding the process of HNSCC pathogenesis and progression caused by ULBP2.